Let our experienced professionals help you:
ENSURE regulatory compliance
IMPROVE operational efficiency
MITIGATE risk and
MAXIMIZE reimbursement

Kentucky Regulatory, Legislative and Reimbursement Report – May-June 2015

Kentucky Regulatory Update

  • Reportable Disease Surveillance Amended Regulation Now In Effect
    • The revised Reportable Disease Surveillance (KAR 2:020) administrative regulation is now in effect, and nursing facilities and personal care facilities are required to comply. A Task Force requested language that would streamline the reporting process, but the Department for Public Health prefers to have over-reporting rather than under-reporting. Included is a revised list of reportable diseases, as well as additional reporting requirements about viral hepatitis, healthcare associated infection surveillance and electronic laboratory reporting of specific diseases and conditions.
    • Two forms referenced in the regulation for reporting are:
    • Amendment to 900 KAR 5:020, 2015-2017 State Health Plan Filed
      • On May 14, 2015, an amendment to 900 KAR 5:020, State Health Plan for facilities and services was filed with the Legislative Research Commission. The State Health Plan is a critical element of the certificate of need process for which the cabinet is given responsibility in KRS Chapter 216B. Click here for a copy of the proposed amendment and here for the red-line version of the State Health Plan, which is incorporated by reference in the administrative regulation.
    • Office of Inspector General Long Term Care Regulations and Statutes
      • Click here for a list of current regulations and statutes.

Kentucky Board of Pharmacy

  • Kentucky Board of Pharmacy issues Guidance for Pharmacists Regarding Buprenorphine
    • The Kentucky Board of Pharmacy released a document titled “Buprenorphine And Buprenorphine/Naloxone Prescribing Regulation, What A Pharmacist Should Know.”
    • Click here for the document.
  • Kentucky Board Of Pharmacy Establishes Regulations, Standards For Dispensing Naloxone
    • SB 192 passed and was signed into law by Governor Beshear during the 2015 Legislative Session. This bill was signed into law as an emergency bill; therefore, this became law on March 25, 2015.
    • This bill allows a pharmacist to dispense naloxone pursuant to a physician-approved protocol. The Board, in consultation with the Kentucky Board of Medical Licensure, shall promulgate administrative regulations to establish certification, educational, operational, and protocol requirements. The administrative regulation developed by the Board includes:
      • Requiring that any dispensing under this law be done only in accordance with a physician-approved protocol, and specifying the minimum required components of any such protocol;
      • A required mandatory education requirement as to the mechanism and circumstances for the administration of naloxone for the person to whom the naloxone is dispensed; and
      • Requiring that a record of the dispensing be made available to a physician signing the protocol, if desired by the physician.
      • A supplemental educational or training component for a pharmacist seeking certification and
      • A limitation on the forms of naloxone and means of its administration that may be dispensed.
    • A pharmacist desiring to achieve certification to initiate the dispensing of naloxone shall complete and submit an “Application for Pharmacist Certification for Naloxone Dispensing”, with the Board.
    • Click here for the application.
  • Kentucky Board of Pharmacy Regulations Committee Revisits LTC Regulation
    • The Kentucky Board of Pharmacy Regulations Committee approved this regulation which includes changes to the emergency supply kit and adds a provision of pharmacy stock in the long term care facility. The regulation was approved by the BOP regulations committee and sent to the KY Board of Pharmacy for review.  It has been listed for public comment.
    • Automated dispensing system sections of the regulation have been removed and will be developed into a separate regulation.

Clinical Update

  • Poison Control Alert – Synthetic Cannabinoid Exposure Is Increasing In Kentucky
    • This alert from the Kentucky Regional Poison Control Center is to provide awareness of the recent increase in exposures to synthetic cannabinoids.
    • These substances go by several names including “spice,” “K2,” “Summit,” “Synthetic Marijuana,” “Crank Weed,” “Pot Pouri,” “Plutonium,” “AK-47,” “Keisha Kole,” or “Bermuda Triangle.”
    • These chemicals are often sprayed on plant material and sold in packaging labeled “not for human consumption.” There are several known Tetrahydrocannabinol (THC)-homologs and often a user does not know the actual chemical they have been exposed to. Although referred to as synthetic marijuana, they act on numerous receptors and pose significant risk to the user.
    • In Kentucky, there is no rapid confirmatory test for these substances. Decisions to treat should be guided by history and clinical picture.
    • Patients often present with the some or all of the following symptoms, and exposure can be life threatening:
      • Agitation, Anxiety Tachycardia, Hypertension Seizures, Dysrhythmias Nausea, Vomiting Muscle spasms, Tremors Hallucinations, Psychosis Suicidal Ideation Other Harmful Thoughts, Actions
    • Treatment is supportive. Benzodiazepines should be used liberally for agitation, psychosis, increased autonomic activity and seizures. Consider 5HT3 antagonist antiemetics (ondansetron, granisetron) for nausea and vomiting. In cases of severe psychosis, antipsychotics should be considered with caution as their efficacy in this setting may be limited and may increase the risk for dysrhythmias.
    • Recently, there have been reports of patients presenting with inconsistent symptoms including CNS depression, respiratory depression and hypotension who, when successfully reversed by naloxone, became immediately agitated. It is not yet known if this is a new substance or a known substance combined with an opioid.
    • The Kentucky Regional Poison Control Center is working with poison control centers nationally to monitor this trend. Please call the Center to discuss any patients you feel may have been exposed to synthetic cannabinoids. The Center’s medical staff is available 24 hours/day, 365 days per year.
      • 1-800-222-1222

Centers for Disease Control

  • CDC $1.9 Million Dollar Grant Approved For Kentucky Infection Prevention In All Health Care Settings
    • Due to emerging infectious diseases, long term care settings will be included in the Kentucky State Regional Infection Prevention and Epidemiology (KSTRIPE) implementation of a $1.9 million grant from the Centers for Disease Control (CDC). This grant will assess all health care settings’ infection prevention and control programs and practices. A portion of the grant will be used for Healthcare Acquired Infection (HAI) training for long term care, and a supplemental three-year grant will be used for the Infection Prevention Boot Camp which includes training material for long term care facilities. The Department of Public Health has also created an Infection Preventionist List Serve for long term care providers to access.

Kentucky Department for Public Health

  • Kentucky Department For Public Health Conducting Research On Antimicrobial Stewardship
    • As part of the nationwide reemphasis upon antimicrobial stewardship practice as a means to combat the problem of antibiotic resistance, the Healthcare-Associated Infection Prevention Program at the Kentucky Department for Public Health is assessing the current state of antimicrobial stewardship practice among all acute care hospitals and long-term care facilities within the Commonwealth. This study will examine those areas the CDC has identified as the core functions of antimicrobial stewardship.  The researchers hope to identify those factors that result in the best outcomes for patients and also identify barriers to good antibiotic stewardship practices and areas of need.  They also hope this data will allow the development of common structures, processes, and benchmarks for antimicrobial stewardship practice for all health care facilities in the Bluegrass.

Pharmacist Provider Status

  • Provider Status Advocacy In Action: Kentucky’s Pharmacists Garner Support From Their Entire House Delegation
    • In addition to Kentucky Representative Brett Guthrie introducing HR 592, the Pharmacy and Medically Underserved Areas Enhancement Act, all of Kentucky’s representatives have signed on to cosponsor this legislation. APhA CEO Thomas E. Menighan highlighted this in a recent blog post.
    • To read the blog, click here.

Quality Innovation Network – Quality Improvement Organizations

  • Kentucky QIO Nursing Home Quality Care Collaborative Kicks Off
    • The National Nursing Home Quality Care Coalition (NNHQCC), created by the Centers for Medicare & Medicaid Services (CMS), unites nursing homes across the nation under one goal—to work together to ensure residents receive the highest possible quality of care. Although the first 18-month collaborative in the coalition started April 1, 2015, there is still time to sign up!
    • For more, click here.

Managed Care Medicaid

  • Passport/Magellan Issue Regarding Vivitrol Injections
    • If you are a pharmacy who has an arrangement with a physician or drug treatment center to either administer Vivitrol injections to their patients or to provide the physician office or drug treatment center with Vivitrol for their patients, you may have had some recent problems with Passport patients.
    • For more, click here.

Comments are closed.